MEDICARE: STEPHANIE R GORDON-MEEK PT

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	2251X0800X	Orthopedic Physical Therapist	1164420	TX

General Provider Information

NPI Number	:	1063779809
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	STEPHANIE R GORDON-MEEK PT

Provider Business Mailing Address
First Line	:	1208 DICKINSON DR
Second Line	:
City	:	MCKINNEY
State	:	TX
Zip	:	75071-7504
Country	:	US
Telephone Number	:	214-504-0645
Fax Number	:

Provider Business Practice Location Address
First Line	:	700 ALMA DR
Second Line	:	#135
City	:	PLANO
State	:	TX
Zip	:	75075-8844
Country	:	US
Telephone Number	:	972-424-5840
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	04/18/2012
Last Update Date	:	04/18/2012

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